Advances in Diabetic Foot Prevention and Care: The Expanding Role of Primary Care Physicians in the Era of Smart Technology and Artificial Intelligence

Abstract

Background: Diabetic foot disease is a leading cause of morbidity, mortality, and healthcare expenditure worldwide, with particularly high prevalence in the Middle East and Gulf Cooperation Council (GCC) countries. Primary care physicians play a pivotal role in early detection and prevention, yet significant gaps persist in screening practices, patient education, and care coordination.

Objective: This narrative review aims to synthesize recent evidence on technological and artificial intelligence innovations in diabetic foot prevention and management, and to examine their integration into primary care practice, with particular attention to high-burden regions such as Saudi Arabia and the GCC.

Methods: A comprehensive literature search was conducted using PubMed, Google Scholar, and international guideline databases. Search terms included "diabetic foot," "primary care," "artificial intelligence," "wearable sensors," "telemedicine," and "prevention." Studies published between 2015 and 2025 were included. Evidence was synthesized thematically to address epidemiology, technological innovations, primary care roles, multidisciplinary approaches, and implementation challenges.

Results: Smart wearable devices enable continuous monitoring of temperature and pressure, facilitating early ulcer detection. AI-powered algorithms achieve >90% sensitivity in automated ulcer detection from smartphone images. Telemedicine platforms demonstrate comparable outcomes to in-person care while reducing costs. Multidisciplinary team approaches reduce amputation rates by 40-80%. However, implementation barriers including insufficient training, time constraints, and limited awareness persist, particularly in resource-limited settings.

Conclusion: The integration of smart technology and AI into primary care offers transformative potential for diabetic foot prevention. PCPs, empowered by these innovations and supported by multidisciplinary teams, can shift the paradigm from reactive treatment to proactive prevention. Addressing implementation barriers through education, policy support, and accessible digital health solutions is essential for realizing this potential and reducing the global burden of diabetic foot complications.